Coronavirus COVID-19 y dolor crónico: incertidumbres Translated title: COVID-19 coronavirus and chronic pain: uncertainties

Chronic pain (CP) seriously affects the patient’s daily activities and quality of life, but few studies on CP have considered its effects on the patient’s social and family environment. In this work, through a review of the literature, we assessed several aspects of how CP influences the patient’s daily activities and quality of life, as well as its repercussions in the workplace, and on the family and social environment. Finally, the consequences of pain on the health care system are discussed. On the basis of the results, we concluded that in addition to the serious consequences on the patient’s life, CP has a severe detrimental effect on their social and family environment, as well as on health care services. Thus, we want to emphasize on the need to adopt a multidisciplinary approach to treatment so as to obtain more comprehensive improvements for patients in familial and social contexts. Accordingly, it would be beneficial to promote more social- and family-oriented research initiatives.

Chronic pain and depressive illness are debilitating disease states that are variably resistant to currently available therapeutic agents. Animal models of chronic pain are associated with activation of the hypothalamo-pituitary-adrenal (HPA) axis, upon which chronic pain acts as an inescapable stressor. Inescapable stress is also associated with 'depressive-like' symptoms in experimental animals. Based on reports of the comorbidity between chronic pain and depressive illness in human patients, it is possible that these disease states are linked, via chronic stress-induced HPA dysfunction. Here, we discuss the possible involvement of the HPA axis in the aetiology of both chronic pain and clinical depression, and suggest a strategy for the development of novel pharmacotherapies.

The primary aim of this study was to better understand the role that social factors (ie, social support, satisfaction in participation with social roles, social isolation, and self-perceived ability to perform social roles and activities) play in pain-related interference and depressive symptoms in adults with chronic pain. Moreover, this study also examined if sex exerts a moderating role in these associations.